Managing Lymphedema for a Better Quality of Life

Before we get into the variety of tools available to manage Lymphedema, let’s discuss what Lymphedema is, how and why it develops, along with its four stages.

Lymphedema is a chronic condition that's all about fluid build-up in the body. Specifically in your lymphatic system. You see, our lymphatic system is the superhero responsible for draining and filtering extra fluid in the body and it helps to fight off infection. When this system gets compromised or damaged, it can cause moderate to severe swelling that never quits. In other words, there is no cure once diagnosed.

Imagine the lymphatic system as a network of vessels, nodes, and organs—like a bustling cityscape for your body's waste products, immune cells, and proteins. Normally, the fluid flows through these vessels, eventually finding its way back into the bloodstream. But when those vessels aren't working their best or when lymph nodes are removed, that fluid can't drain properly. It's like a traffic jam in your tissues!

There are two types of lymphedema you should be aware of. Primary lymphedema is a rare, inherited condition that can show itself in the early stages of life, or surprise you later in life. Then there's secondary lymphedema, the more common troublemaker. It likes to show up when your lymphatic system takes a hit from surgery, radiation, infection, trauma, or even cancer. It can suddenly appear, or gradually get worse over time.

The classic sign of lymphedema is swelling that won't quit. Usually, swelling occurs in the arms and legs, but it can target other body parts. And this usually comes with some unpleasant sensations like heaviness, tightness, discomfort, or even pain.

Lymphedema is typically categorized into four stages based on the severity of the condition. These stages help healthcare professionals assess the progression and help them determine proper treatment.

Stages of Lymphedema

Stage 0 (Latency Stage): In this stage, there are no visible signs of swelling, but the patient may experience symptoms such as heaviness, discomfort, or aching in the affected area. The swelling may not be apparent, but changes in the tissues can be detected through specialized diagnostic techniques.

Stage 1 (Mild Stage): This stage involves mild swelling that is usually reversible with elevation and rest. The affected area may appear soft and pitting (indentation occurs when pressure is applied), and the skin texture may remain normal. Symptoms such as heaviness and discomfort may persist.

Stage 2 (Moderate Stage): At this stage, the swelling becomes more persistent and does not easily resolve with elevation or rest. The affected area may appear firmer, and the skin texture might show changes like thickening or fibrosis. The development of recurrent infections and increased risk of complications is more common in this stage.

Stage 3 (Severe Stage): This is the most advanced stage of lymphedema. The swelling becomes more pronounced and irreversible. The affected area may appear significantly enlarged, with extensive changes in the skin, such as hardening, thickening, and folds. Recurrent infections, decreased mobility, and potential complications like ulcerations and lymphangiosarcoma (rare) are associated with this stage.

Over time, if left unchecked, lymphedema can cause your skin to become fibrotic (toughen up and thicken). It can invite unwelcome infections for repeat visits. And as if that's not enough, it might even make you feel less mobile and lower your overall quality of life.

It's important to note that lymphedema is a progressive condition, and the severity can vary from person to person. Early detection and intervention are crucial to prevent the progression of lymphedema and minimize its impact on the physical and mental health of each person.

Tips for Managing Lymphedema

*As always, be sure to talk to your doctor before trying anything new *

Unfortunately, lymphedema doesn't have a cure, but you can manage the symptoms with some lifestyle adjustments and specially designed compression products. Here are some helpful tips for managing lymphedema to keep the quality life you deserve:

1. Find an expert in Lymphedema treatment and therapy: There are trained therapists who specialize in the treatment of lymphedema (CLT: Certified Lymphedema Therapist). Many of these therapists have direct training from various sources, manufacturers, and specialists in lymphedema. A good CLT can make all the difference on your lifelong journey of managing Lymphedema. You can use these free directories to find a CLT in your area, LANA Certified Specialists and Dr. Vodder School
2.  Purchase the correct type of compression garment: Not all compression garments are designed to treat lymphedema and not all compression garments are created equal. In fact, most off-the-shelf (stockings you can buy online) are circular-knit compression stockings that should not be worn if you have Stage 2-3 lymphedema, or if you have large creases or lobes of tissue. For difficult cases, one should consider using a product like the circaid juxtafit (leg or arm). compression wrap. The juxtafit wrap is designed specifically for lymphedema patients thanks to the inelastic properties of the material. The material used in circaid’s inelastic products act like a wall, supporting your tissue and effectively improving the body's natural method of circulating fluid. Additionally, inelastic wraps like the circaid juxtafit can be worn 24/7! Unlike elastic circular-knit stockings that can only be worn during the day. The key is to find the right product for what you're dealing with. 
3. Wear the proper compression garment every day: Sure, this doesn’t sound appealing, but you need to remember that Lymphedema is a chronic condition that can’t be ignored. By wearing the proper compression garment, every day, you will effectively manage swelling, which will reduce your risk of other complications (i.e. skin breakdown, fibrotic tissue, open wounds, more advanced stages of lymphedema). Proper compression therapy can be the difference between having a normal life or one that is challenging and difficult to manage. It’s best to make it part of your daily routine as soon as possible.
4. Proper Exercise: How does exercise help with lymphedema, specifically? When you move, your muscles help to squeeze your blood, and lymphatic vessels, moving fluid through the body to recirculate naturally. This is essentially the same concept of what wearing the proper compression garment will do. A garment like the circaid juxtafit pushes against the flexing muscles, further pumping the fluid out of the affected area. However, just like with compression garments, not all exercises are a good idea. In fact, depending on the severity of lymphedema, some exercises can be counterproductive. For example, walking on a treadmill if you have moderate to severe lymphedema in your legs can make things worse because your legs are feeling the full force of each step along with gravity. The swelling will likely get worse. So, what types of exercise can a lymphedema patient perform? It really depends on the patient, his or her condition, and whether a doctor has given clearance for exercise. If given clearance, the best exercise to reduce leg swelling would be swimming because the person is horizontal, in motion, and performing a non-impact movement. Standing in water is also helpful because the natural weight of water and the deeper level will put more pressure at the lowest point and reduce as you get closer to the surface. This is the same principle found in graduated compression stockings (more pressure at the lowest point that reduces as it gets higher). Another good exercise for lower extremity lymphedema would be riding a recumbent bike. It is also non-impact, provides a steady motion, and the legs are slightly elevated. The key here is to talk to your doctor and therapist about the best exercises to perform based on your specific needs.
5. Practice helpful skincare rituals: First and foremost, you will want to keep your skin clean. Lymphedema increases your risk of infection, so make sure your skin is cleaned daily. You’ll want to ensure your skin isn’t dried out, so you should look for mild soaps that are hypoallergenic and have a low pH. Be sure to avoid products with perfumes and dyes. When you’re done cleaning your skin it’s important to dry it thoroughly to prevent bacteria from growing due to excess moisture. You also want to make sure your skin isn’t dried out and properly moisturized. Look for a moisturizer that doesn’t contain any harsh chemicals or additives. You will also want to avoid soaking in hot water because it will cause your vessels to expand and increase swelling. And when shaving, you should consider using an electric razor to avoid cutting yourself. Even the smallest cut can turn into an infection. Electric razors are a lot safer than a manual razor. Finally, it’s important to monitor your skin daily for any complications. If necessary, have a loved one help you review any hard-to-reach areas.
6. Dietary adjustments: According to a recent article published in the Journal of Preventative Medicine and Hygiene (JPMH), there isn’t a specific diet that has been proven to be of high therapeutic value for patients with Lymphedema. Nevertheless, specific dietary tips could help reduce symptoms. Here are the tips found in the article: Fibers present in fruits and vegetables lead to the formation of short-chain fatty acids in the bowel, which exhibit an anti-inflammatory activity [32, 47]. Other anti-inflammatory dietary molecules, such as Omega-3, and several spices (turmeric, garlic, and curry leaves) may reduce inflammation and edema [32, 48]. On the contrary, foods such as salt, caffeine, omega 6 or 9, alcohol, and sweets exert the opposite effect [32, 49]. Thus, they should be avoided by patients with lymphedema. Finally, foods can control the physiologic hormonal response, which in turn influences inflammation and edema [32]. In summary, if you have lymphedema, you should avoid salty foods, caffeine, alcohol, omega 6 or 9, and foods with sugar or sweeteners.

Remember, early detection and swift action are the superheroes in this story. Spotting lymphedema early on and getting the right help can stop it from progressively getting worse. And because there is no cure for lymphedema, it’s important to adopt habits and lifestyle changes that can positively impact your journey on managing lymphedema. But more importantly, to understand what things in your life to avoid.